Pertussis (Whooping Cough) Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 9, 2020

What is Pertussis?

Bordetella pertussis is the bacteria that causes whooping cough. The cough of Pertussis can make breathing hard and is especially dangerous for infants and young children.

Pertussis is a vaccine preventable disease though it is possible to contract a milder form even if vaccinated. Whooping cough generally occurs in 3 stages:

  1. Catarrhal: a period of cold symptoms usually without fever. This is the most contagious stage though most aren’t aware at this time that they have pertussis
  2. Paroxysmal: characterized by a harsh and persistent ‘whooping’ cough. Whooping is caused by forceful breathing in after a coughing attack
  3. Convalescent: symptoms steadily improve over weeks to months. 

How is Pertussis Diagnosed and Treated?

Diagnosis of pertussis should be suspected if:

  • Coughing fits with or without whooping
  • Pronounced, prolonged cough with persistent, clear runny nose
  • A cough characterized by:
    • Whooping (loud, forced inspiration)
    • Periods where your child stops breathing (apnea), 
    • Vomiting from coughing so hard 
    • Burst blood vessels in the whites of the eyes
    • Cough that disrupts sleep
  • Bluish facial discoloration (cyanosis)
  • Sweating episodes between coughing fits

While pertussis can be diagnosed by history and exam, it can be confirmed by a laboratory test after swabbing your child’s nose.

How to Treat Pertussis

  • Supportive care: ensure your child drinks plenty of fluids. Anti-cough medications are not recommended. Tylenol and ibuprofen can be used for discomfort and fever.
  • Antibiotics: the decision to start antibiotics should be made in conjunction with your child’s provider. Antibiotics started close to the beginning of the illness are most effective
  • Household contacts: your child’s provider might recommend treating members of your household with antibiotics preventatively
  • Prevention: make sure your child is vaccinated. Even children who have had pertussis should continue to be vaccinated against it according to the recommended vaccine schedule

When can my child return to school?

A child can return to school post-pertussis when:

  • They have received 5 days of antibiotic treatment, or
  • If not treated with antibiotics, at least 21 days have passed since symptoms started

Check with K if…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a doctor in person if…

  • Your child is having a hard time breathing
  • Your child develops a high fever
  • Your child is unable to drink to stay hydrated
  • Your child looks lethargic or extremely tired
  • Your child develop a high fever
  • Your child is less less than 4 months old 
  • Your child has a seizure
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.